ArticleClinical research in cardiology : official journal of the German Cardiac Society2015
Effectiveness of aldosterone antagonists for preventing atrial fibrillation after cardiac surgery in patients with systolic heart failure: a retrospective study.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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12 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Effects of Mineralocorticoid Receptor Antagonists on Atrial Fibrillation Occurrence: A Systematic Review, Meta-Analysis, and Meta-Regression to Identify Modifying Factors.Journal of the American Heart Association · 2019Pooled it
- The effect of spironolactone in reducing the risk of postoperative atrial fibrillation in patients undergoing coronary artery bypass graft surgery: randomized single-blind placebo-controlled study.General thoracic and cardiovascular surgery · 2025Trial
- Safety and efficacy of tolvaptan sodium phosphate in patients undergoing open-heart surgery.Surgery today · 2026Article
- Mineralocorticoid Receptor Antagonism Reduces Atrial Arrhythmias Post-Cardiac Surgery and Attenuates Atrial Stress Responses to Cardioplegic Arrest.Journal of the American Heart Association · 2025Article
- Prediction of endogenous mineralocorticoid receptor activity by depressor effects of mineralocorticoid receptor antagonists in patients with primary aldosteronism.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Article
- Overweight and aging increase the risk of atrial fibrillation after cardiac surgery independently of left atrial size and left ventricular ejection fraction.Journal of cardiothoracic surgery · 2020Article
- Management of primary aldosteronism and mineralocorticoid receptor-associated hypertension.Hypertension research : official journal of the Japanese Society of Hypertension · 2020Review
- Underutilization of Aldosterone Antagonists in Heart Failure.Hospital pharmacy · 2017Article
- Monocyte-platelet aggregates and CD11b expression as markers for thrombogenicity in atrial fibrillation.Clinical research in cardiology : official journal of the German Cardiac Society · 2016Article
- Third-generation Mineralocorticoid Receptor Antagonists: Why Do We Need a Fourth?Journal of cardiovascular pharmacology · 2016Review
- Effects of spironolactone on ventricular-arterial coupling in patients with chronic systolic heart failure and mild symptoms.Clinical research in cardiology : official journal of the German Cardiac Society · 2015Article
- Short-course of ranolazine prevents postoperative atrial fibrillation following coronary artery bypass grafting and valve surgeries.Clinical research in cardiology : official journal of the German Cardiac Society · 2015Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Postoperative atrial fibrillation (POAF) is the most common arrhythmia after cardiac surgery. There exist consistent experimental and clinical data suggesting that aldosterone antagonists (AAs) may exert beneficial effects regarding electrical and structural remodeling in failing myocardium. Recently, eplerenone (EPL) has been found to reduce the incidence of nonsurgical AF when added to guideline-recommended therapy in patients with systolic heart failure. Based on these findings, we primarily aimed to evaluate by retrospective analysis the impact of the two AAs, EPL and spironolactone (SPL), given at standard therapeutic doses in preventing new-onset POAF in patients the majority of which had a preoperative ejection fraction (EF) below 40%. A total of 332 patients (298 men/34 women, mean age 64.3 ± 9 years) without history of AF were included in this analysis; 132 of these patients received long-term EPL or SPL in addition to beta-blockade/statins therapy and 200 patients received neither EPL nor SPL. All patients underwent on-pump coronary artery bypass graft (80%) and/or valvular surgery (20%). In the nonAA group (EF = 35.8 ± 6%) 90/200 patients (45%) had POAF, while in the AA group (EF = 36.2 ± 5%) only 40/132 patients (30.3%) developed POAF (P < 0.01, χ (2) test). Multivariate logistic regression analysis revealed that only AAs and left atrial diameter significantly affected the development of POAF even when adjusted for other clinical variables (P < 0.05). In conclusion, AAs significantly reduced the incidence of POAF when added to standard heart failure therapy in patients undergoing on-pump cardiac surgery.
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